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Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary
  1. K Mackway-Jones
  1. Department of Emergency Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL
  1. Correspondence to: Kevin Mackway-Jones, Consultant (kevin.mackway-jones{at}

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Edited by K Mackway-Jones

Best evidence topic reports (BETs) summarise the evidence pertaining to particular clinical questions. They are not systematic reviews, but rather contain the best (highest level) evidence that can be practically obtained by busy practising clinicians. The search strategies used to find the best evidence are reported in detail in order to allow clinicians to update searches whenever necessary.

The BETs published below were first reported at the Critical Appraisal Journal Club at the Manchester Royal Infirmary.1 Each BET has been constructed in the four stages that have been described elsewhere.2 Four positive and two negative BETs are reported in this issue of the journal. The six topics covered in this issue of the journal are: For the first time “Guest BETs” are also included. The four BETs shown below were first presented at the monthly Academic Specialty Training in Emergency Medicine (STEM) meetings of the Specialty Registrars on the North Western training scheme.

Positive BETs

  • Ingested coins and metal detection

  • Regional anaesthesia for femoral shaft fractures in children

  • Activated charcoal in paracetamol overdose

  • Management of uncomplicated soft tissue gunshot wounds

Negative BETs

  • Repair of partial lacerations of the extensor tendons of the hand

  • Early management of displaced nasal fractures

Guest BETs

  • Antibiotics in base of skull fractures

  • Glucose or glucagon for hypoglycaemia

  • Closure of pretibial lacerations

  • Digital or metacarpal block for finger injuries

Edited by K Mackway-Jones